BenEzra D, Cohen E, Rakotomalala M, de Courten C, Harris W, Chajek T, Friedman G, Matamoros N
Pediatric Ophthalmology and Immuno Ophthalmology Unit, Hadassah University Hospital, Jerusalem, Israel.
Transplant Proc. 1988 Jun;20(3 Suppl 4):122-7.
Thirty patients suffering from severe sight-threatening bilateral chronic endogenous uveitis were treated with initial dosages of 10 mg/kg/d of CsA. After 1 month of therapy, all patients but one demonstrated a rapid decrease of the intraocular inflammatory processes along with an arrest of the deterioration of vision. After 1 year (or more) of treatment, most patients still show the same visual acuity achieved after 1 month. During the 3-year span of this study, attempts at tapering off the CsA dosage to less than 5 mg/kg/d induced a temporary flare-up in 20 of the 24 patients followed without interruption for more than 6 months. Nonetheless, control of the intraocular inflammation was finally achieved by 5 mg CsA/kg/d or less in 14 of the 25 patients. In six of these 14 patients the CsA dosage was further tapered to total discontinuation. Two of the six patients showed a rapid reactivation of the intraocular inflammatory processes with a profound decrease in vision within 1 and 3 weeks, respectively. In four patients, control of the intraocular inflammation and preservation of good visual acuity have been observed for a period of up to 18 months.
30例患有严重威胁视力的双侧慢性内源性葡萄膜炎的患者接受了初始剂量为10mg/kg/d的环孢素A（CsA）治疗。治疗1个月后，除1例患者外，所有患者的眼内炎症过程均迅速减轻，同时视力恶化停止。治疗1年（或更长时间）后，大多数患者的视力仍保持在1个月时达到的水平。在本研究的3年期间，对24例连续随访超过6个月的患者尝试将CsA剂量减至5mg/kg/d以下，其中20例出现了暂时的炎症复发。尽管如此，25例患者中有14例最终通过5mg CsA/kg/d或更低剂量实现了眼内炎症的控制。在这14例患者中的6例中，CsA剂量进一步逐渐减少直至停药。这6例患者中有2例分别在1周和3周内眼内炎症过程迅速重新激活，视力大幅下降。在4例患者中，观察到眼内炎症得到控制且保持了良好的视力，长达18个月。
